CMS Price Transparency Data

Culture, bacterial

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $20
  • Cash Discount Price: $85
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Independence Health System Butler Memorial Hospita is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.32x the Medicare baseline. Located in One Hospital Way, Butler, PA.
Cash / Self-Pay
$85

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.62

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.62 (100%)
Cash / Self-Pay: $85 (986%)
Insurance Median: $20 (232%)
Cash: $85 (986% of Medicare)
Ins. Median: $20 (232% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.62 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 232% of the Medicare baseline (a markup of 132%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $7 81%
UnitedHealthcare $7 - $10 81%
Upmc $7 - $128 81%
Aetna $8 - $98 93%
Amerihealth $8 - $9 93%
Highmark $8 - $23 93%
Martin'S Point - Usfhp $8 - $43 93%
Tricare $8 93%
American Health Plan $9 104%
Devoted Health Plan $9 - $49 104%
Gateway $9 - $128 104%
Geisinger $9 - $122 104%
Humana $9 104%
Jefferson Health Plan $9 104%
Life Butler County $9 104%
Medicare (plans) $9 104%
Pa Health & Wellness $9 104%
Peak Health $9 - $85 104%
Pnoa $9 - $98 104%
Provider Partners $9 104%
The Health Plan $9 - $20 104%
Highmark Aca - Direct Blue $11 - $23 128%
Cigna $13 - $61 151%
Ellwood Group $17 - $52 197%
Highmark Community Blue $18 - $23 209%
Highmark - Ind.& Managed Care $20 - $23 232%
Ccbh - Behavioral Health $29 - $61 336%
Workers Comp $35 406%
Private Healthcare Systems $85 - $104 986%
Devon $92 1067%
Intergroup $98 1137%
Multiplan $110 1276%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Way, Butler, PA 16001
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals